A systematic review found that early antibiotic exposure, high socioeconomic status, and urban living increased the risk for pediatric IBD.

Recognizing both modifiable and non-modifiable pediatric causative factors can help identify children at an increased risk for inflammatory bowel disease (IBD). The systematic review, presented by Nisha Thacker, PhD-candidate at DDW 2023, aimed to explore the correlation between dietary habits and environmental exposure and pediatric IBD diagnosis. Out of the 4,763 studies examined, the researchers analyzed 35 observational studies that included 461,490 participants.

The study found a higher likelihood of pediatric IBD diagnosis among individuals who were exposed to antibiotics in early childhood (OR, 4.54; 95% CI, 1.47-14.02; P=0.009), those who had one to four antibiotic courses (OR, 2.55; 95% CI, 1.79-3.65; P≤0.001), and those who had more than four antibiotic courses during childhood (OR, 3.46; 95% CI, 2.14-5.60; P≤0.001). Additional factors, including high socioeconomic status (OR, 2.55; 95% CI, 1.40-4.63; P=0.002) and urban living (OR, 1.70; 95% CI, 0.96-3.00; P=0.067), significantly increased the risk for pediatric IBD.

Dietary patterns also played a significant role. Regular or high intake of vegetables was associated with a lower risk for pediatric IBD (OR, 0.47; 95% CI, 0.2-1.06; P=0.067), whereas regular intake of sugary beverages and candies conferred a higher risk (OR, 2.02; 95% CI, 1.06-3.85; P=0.033).

The understanding of pediatric IBD risk factors is evolving. It is becoming increasingly evident that early-life environmental and dietary exposures significantly influence these risks. Prevention strategies should be comprehensive, considering antibiotic use, dietary habits, lifestyle factors, and microbiome health. Continuous research is needed to refine research and aid in the development of more effective strategies to prevent pediatric IBD.

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